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CMS NEWS – Medicaid Cuts Shift Healthcare Costs to Broader Public

CMS NEWS – Medicaid Cuts Shift Healthcare Costs to Broader Public


Alternative Headline: Medicaid Cuts Raise Hidden Costs


[MM Curator Summary]: Medicaid budget cuts shift costs to hospitals, private insurers, and the broader economy instead of creating real savings.

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Budget reductions to Medicaid programs may appear to offer immediate financial relief for government spending. Still, evidence suggests these cuts often result in widespread cost increases that affect the entire healthcare system.

The Hidden Cost TransferEconomic Impacts Beyond HealthcareCost Shifting to Private InsurancePublic Health Considerations

When policymakers face budget constraints, Medicaid frequently becomes a target for spending reductions. As one of the largest items in many state budgets, the program presents an attractive option for officials looking to address fiscal challenges. However, financial experts and healthcare analysts warn that such cuts can create a ripple effect throughout the healthcare ecosystem.

Reducing Medicaid coverage doesn’t eliminate healthcare needs – it simply shifts where and how those needs are addressed. When individuals lose Medicaid coverage, they don’t stop getting sick or requiring medical attention. Instead, they often delay care until conditions worsen and require emergency intervention.

Hospitals and emergency departments become the default providers for uninsured patients, delivering care that is both more expensive and less effective than preventive services. These facilities are legally required to treat patients regardless of insurance status, resulting in uncompensated care costs that must be absorbed somewhere in the system.

Cutting Medicaid can seem like an easy way to slash the budget. But, the costs can spread to all of us.

Economic Impacts Beyond Healthcare

The financial consequences extend beyond direct healthcare costs. When people lack access to regular medical care, workforce productivity suffers as preventable illnesses lead to increased absenteeism and disability. Families facing medical bankruptcies experience financial instability that affects local economies.

State economies also feel the impact through reduced federal matching funds. For every dollar a state cuts from Medicaid, it loses multiple dollars in federal funding that would otherwise circulate through the local healthcare economy, supporting jobs and services.

Cost Shifting to Private Insurance

Healthcare providers typically respond to Medicaid reimbursement reductions by shifting costs to private insurersThis practice, known as cost-shifting, results in higher premiums for those with private insurance coverage. Research indicates that hospitals and medical practices often increase charges to privately insured patients to compensate for losses from public programs.

The resulting premium increases affect employers and employees alike, with businesses facing higher costs for providing health benefits and workers experiencing reduced wages as employers allocate more resources to healthcare.

Public Health Considerations

Medicaid reductions can also compromise public health initiatives. The program funds critical preventive services including:

  • Vaccination programs
  • Maternal and child health services
  • Chronic disease management
  • Substance abuse treatment

When these services become less accessible, communities may experience increased rates of preventable diseases and complications, creating additional healthcare demands and costs.

Public health officials note that Medicaid plays a crucial role in addressing health disparities and providing care to vulnerable populations. Reductions in coverage can exacerbate existing inequalities and create long-term social costs.

As budget discussions continue at state and federal levels, policymakers face difficult choices about program funding. However, the evidence suggests that Medicaid cuts rarely produce the straightforward savings they promise. Instead, they often result in cost transfers that ultimately affect taxpayers, businesses, and individuals throughout the economy.

Healthcare economists recommend that budget planners consider these broader implications when evaluating potential changes to Medicaid funding, recognizing that short-term budget reductions may lead to larger long-term costs across multiple sectors of society.

https://www.considerable.com/medicaid-cuts-shift-healthcare-costs-to-broader-public/



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CMS NEWS – Medicaid Cuts and Long-Term Care Quality & Access

CMS NEWS – Medicaid Cuts and Long-Term Care Quality & Access


Alternative Headline: Medicaid Cuts Threaten Elder Care


[MM Curator Summary]: Medicaid cuts under Trump’s bill will reduce access to long-term care, hitting seniors and home services hardest.

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The One Big Beautiful Bill Act (OBBBA) is projected to cut Medicaid benefits by over $1 trillion. How will these cuts affect long-term care? The law will likely result in worsening quality of care and access to nursing homes and home-based care, said LDI’s Executive Director Rachel M. Wernerspeaking on the Make Me Smart podcast with Marketplace’s Kimberly Adams.     

Werner said there will also be large differences state-by-state, and the benefits you get may depend on where you live in. So, it’s crucial to plan ahead for long-term care.   

Here are eight points from Dr. Werner’s interview on July 16, 2025.

1. OBBBA Cuts “Provider Taxes”—a Key Funding Source for Medicaid

States use taxes on health care providers and insurers to boost their share of Medicaid funding and draw matching federal funds. The new bill limits both existing and new provider taxes, cutting off a major funding pipeline.

Rachel M. Werner, MD, PhD

2. The Loss of Coverage Will be Widespread and Hit Some Seniors

Roughly 11.8 million Americans, including 1.3 million older adults on both Medicare and Medicaid, could lose access to Medicaid due to these funding cuts, according to the Congressional Budget Office.

3. Long-Term Care Will Suffer

Medicaid is the primary payer for long-term services for older adults and people with disabilities, including nursing home and in-home care. With less funding, quality and access will decline.

4. Home Care May Be Hit Hardest

Medicaid is required to pay for nursing home care, but home and community-based services are optional. So states are likely to cut these benefits first, reducing options for people who want to live independently at home.

5. Family Caregivers Will Shoulder More Burden

As formal care options shrink, unpaid family caregivers will likely have to fill in the gaps, taking on more emotional, physical, and financial burdens.

6. Where You Live Will Matter More

Medicaid programs are state-run, and the generosity of care varies across states. With reduced federal funding, wealthier states might fill the funding gap; poorer ones may reduce services—deepening geographic inequality.

7. Workforce Crisis Will Get Worse

Medicaid cuts may drive down pay for already underpaid care workers. Combined with immigration restrictions and delayed nursing home minimum staffing mandates, we could see even more severe shortages in both nursing homes and home care.

8. Plan for Long-Term Care Before You Need it

Medicare does not cover long-term care, so know your state’s Medicaid rules and start saving early.Medicaid eligibility also varies across states and requires planning. If you don’t qualify for Medicaid, you’ll need personal savings or unpaid family help. Start preparing now to avoid tough choices later.

https://ldi.upenn.edu/our-work/research-updates/how-medicaid-cuts-will-affect-quality-and-access-in-long-term-care/



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STATE NEWS – Louisiana Medicaid Increased Physician Reimbursement Rates Beginning July 1, 2025

STATE NEWS – Louisiana Medicaid Increased Physician Reimbursement Rates Beginning July 1, 2025


Alternative Headline:  Louisiana Boosts Medicaid Pay


[MM Curator Summary]: Louisiana will raise Medicaid physician reimbursement rates to 85% of Medicare levels starting July 2025.

==============================


– The Louisiana Department of Health (LDH) announced an increase in Medicaid reimbursement rates for physicians through funding authorized by Act 306 of the 2024 Regular Legislative Session and appropriated in House Bill 1 of the 2025 Session.

Effective July 1, 2025, Medicaid physician reimbursement rates will increase to 85% of the March 2024 Region 99 Medicare rates for applicable services. Reimbursements at or above this threshold will remain the same.

To implement the new rates, LDH has initiated the formal rulemaking process and submitted a state plan amendment to the Centers for Medicare and Medicaid Services (CMS). An emergency rule was published in the July 2025 edition of the Louisiana Register with the effective date of July 1, 2025, allowing the rate increase to take effect while the final rule is being finalized.

What Providers Need to Know:

  • No action is required from providers. All eligible Medicaid claims with service dates on or after July 1, 2025, will be automatically recycled by LDH and the managed care organizations (MCO) to reflect the updated reimbursement amounts.
  • revised Medicaid fee schedule will be posted on LDH’s website by September 30, 2025.
  • Once the fee schedule is published, MCOs will have 30 calendar days to implement the new rates.
  • LDH will issue an informational bulletin with additional details before the online posting of the revised fee schedule.

For updates and more information, providers are encouraged to monitor LDH communications.

https://ldh.la.gov/news/7537


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STATE NEWS – Vance brazenly lies about cuts to Medicaid in his home state

STATE NEWS – Vance brazenly lies about cuts to Medicaid in his home state


Alternative Headline: Vance Defends Medicaid Cuts


[MM Curator Summary]: JD Vance falsely claimed most Ohioans will retain Medicaid under Trump’s new policy, despite analysis showing massive coverage losses.

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The wildly unlikeable Vice President JD Vance returned to his home state of Ohio on Monday, speaking at a steel plant in Canton. When asked about the “hundreds of thousands of Ohioans” whose Medicaid coverage is in jeopardy as a result of President Donald Trump’s “One Big, Beautiful Bill,” Vance simply lied.

A cartoon by Clay Bennett.

“Well, what I’d say to those Ohioans is one: Don’t believe every false media report that you’ve heard because our explicit goal in the Trump administration is to protect people’s health care, so long as they’re working hard, playing by the rules,” he claimed. 

He then went on to make a false assertion about who will lose their Medicaid.

“Now, there have been a lot of lies out there. And if, for example, you’re an able-bodied person and you’re searching for work, you still got access to Medicaid. If you’re a single mom and you need access to that health care to make sure your kids can go see a doctor, you’re still going to have access to that Medicaid,” Vance said. “Who’s not going to have access to that Medicaid is people who are in the United States illegally and people who refuse to even look for a job."

Meanwhile, an analysis from the Ohio-based Center for Community Solutions found that up to 450,000 Ohio residents are at risk of losing their health insurance once the GOP’s Medicaid work requirement waiver takes effect. 

The policy resembles Arkansas’ failed 2018-2019 experiment, which not only failed to boost employment but also increased red tape, causing more than 18,000 people to lose their health insurance.

The conservative myth that millions of people live comfortably by lazily subsisting off of meager entitlements has been debunked repeatedly. But now the Trump administration is pushing a new myth: that citizens will work low-wage jobsvacant due to the mass deportations of immigrant workers—in exchange for the poor and often inaccessible health insurance available to farmworkers.

We’ll see how that works out.

https://www.dailykos.com/stories/2025/7/28/2335623/-Vance-brazenly-lies-about-cuts-to-Medicaid-in-his-home-state



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TECH – Unite Us and Nomi Health Partner to Accelerate and Streamline Payments for Community-Based Organizations Serving Medicaid Managed Care Organizations

TECH – Unite Us and Nomi Health Partner to Accelerate and Streamline Payments for Community-Based Organizations Serving Medicaid Managed Care Organizations


Alternative Headline: Faster CBO Payments Launched


[MM Curator Summary]: Unite Us and Nomi Health have partnered to accelerate and simplify payments to community-based organizations supporting healthcare delivery, especially in Medicaid Managed Care organizations. 

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NEW YORK–(BUSINESS WIRE)–Unite Us, the nation’s trusted technology partner integrating health and community-based care, and Nomi Health, a leading national healthcare financial services platform, today announced a strategic partnership to deliver an innovative joint solution designed to dramatically streamline administration and accelerate payments to community-based organizations (CBOs) on behalf of healthcare payers.

New partnership pairs Unite Us’ billing capabilities with Nomi Health’s payment system to enhance financial flows for community services.

This strategic partnership will directly address a critical pain point for CBOs: the slow and unpredictable payment processes that hinder their financial stability and ability to deliver vital services. By integrating the Unite Us and Nomi Health platforms, the partnership ensures that essential community services are efficient and sustainably funded through faster, more reliable reimbursements.

“Nomi Health is committed to eliminating the friction points in healthcare, and this partnership with Unite Us extends that commitment directly to the community level,” said Mark Newman, founder and CEO at Nomi Health. “Our platform is built to eliminate costly administrative processes and accelerate cash flow. Together with Unite Us, we are removing the traditional roadblocks that have prevented CBOs from being reimbursed efficiently. This means less paperwork, more predictable funding, and ultimately, more resources directed towards direct patient care and community well-being.”

Historically reliant on grants, CBOs often struggle to adapt to healthcare reimbursement models, facing operational strain from delayed payments. This new integrated solution dramatically reduces these payment delays, improving financial health for the organizations on the front lines serving the most vulnerable populations. Once a claim (837) is submitted to the healthcare payer through the Unite Us platform, Nomi Health seamlessly facilitates the end-to-end payment process through its platform, delivering funds to CBOs significantly faster than what they see today.

For healthcare payers, the partnership offers an efficient, automated pathway to financially support their community based-partners, ensuring consistency in program execution and broader reach into vulnerable populations. By automating and accelerating the payment process from claim submission to direct funding, healthcare payers can now provide their CBO partners with the consistent cash flow needed to sustain and expand critical services, ultimately strengthening their entire community-based ecosystem.

“Our partnership with Nomi Health is a game-changer for healthcare payers and CBOs nationwide,” said Dan Brillman, co-founder and ceo at Unite Us. "For too long, the financial backbone of community based services has been strained by slow, complex payment processes. By integrating Nomi Health’s modern payment system with our reimbursement solutions, we are not just speeding up payments; we are fundamentally empowering CBOs with the efficiency and financial health they need to expand their impact and focus on delivering critical care and support to those who need it most. This is a monumental step towards a truly integrated and efficiently managed continuum.”

Key Features of the Joint Solution:

  • Streamlined Reimbursement Workflow: Unite Us simplifies the entire reimbursement process, facilitating accurate tracking, submission, and approval of services with unparalleled efficiency.
  • Faster Payments: Nomi Health’s advanced banking infrastructure significantly shortens payment cycles, ensuring dollars are in the hands of CBOs faster than ever before.
  • Reduced Administrative Burden, Increased Impact: Nomi Health assumes the administrative load, drastically cutting down on the paperwork and manual effort traditionally required to process reimbursements, allowing CBOs to dedicate more resources to their core mission.
  • Enhanced Financial Stability for Local Organizations: More predictable and accelerated cash flow fosters sustainability and amplifies impact at the community level, all powered by trusted technology built to scale geographically across states and across diverse service areas.

Together, Unite Us and Nomi Health are building a more integrated, resilient, and responsive health and human service ecosystem—starting with the organizations at its foundation.

For more information about the Unite Us and Nomi Health partnership and its impact on community-based organizations, including how non-profit CBOs can use the Unite Us platform free of charge, please visit uniteus.com/contact/.

About Unite Us:

Unite Us is the nation’s premier technology provider for integrating health and community-based care. Our advanced product suite is used to proactively coordinate services using data-driven insights, streamline referral and case management, and facilitate eligibility assessments and reimbursements across government, healthcare, health plans, and community organizations. The first of its kind, our closed-loop referral system prioritizes privacy and dignity and has integrated data and analytics tools used to measure impact, optimize programs, and shape policy. With over 1.7M services, we host the nation’s largest network of community-based health and economic services dedicated to improving whole-person health. Learn more at UniteUs.com and LinkedIn.

About Nomi Health:

Nomi Health is rebuilding healthcare through its direct model. Founded in 2019, the company’s integrated platform combines analytics, pharmacy management, direct provider networks and payment solutions – providing the infrastructure that powers better healthcare for self-insured employers. The company serves 4,000 customers nationwide, impacting 30 million lives and influencing over $150 billion in healthcare spend. Based in Orem, Utah, Nomi Health leads the movement to rebuild America’s healthcare system.


https://www.businesswire.com/news/home/20250723566547/en/Unite-Us-and-Nomi-Health-Partner-to-Accelerate-and-Streamline-Payments-for-Community-Based-Organizations-Serving-Medicaid-Managed-Care-Organizations


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CMS NEWS – Could the Big Beautiful Bill’s Medicaid cuts shift work, expenses to the county level?

CMS NEWS – Could the Big Beautiful Bill’s Medicaid cuts shift work, expenses to the county level?


Alternative Headline: Counties May Shoulder Medicaid Burden


[MM Curator Summary]: Medicaid changes under Trump’s bill could overwhelm local governments with new workloads and financial penalties.

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WATERTOWN, New York (WWNY) – President Trump’s Big Beautiful Bill aims to save money at the federal level. However, there’s reason to believe that as you save in Washington, you will end up paying more at the local level.

When it comes to Medicaid, President Trump’s bill requires able-bodied workers to check in and prove they are eligible for Medicaid.

There are currently 32,000 people in Jefferson County on Medicaid. At last check, around 6,000 are considered “able-bodied workers.”

Under Donald Trump’s recent Big Beautiful Bill, those people would need to essentially prove they are working or looking for work every six months.

“Early indications are that the work requirements and the recertification are going to be somewhat burdensome on counties,” said Jefferson County Administrator Ryan Piche. “If there’s 6,000 people that need to come through DSS now twice a year, and then go through The WorkPlace twice a year and seek employment opportunities and prove they’re seeking employment opportunities, that’s potentially 24,000 touch points the county government has to account for.”

That means a much bigger workload and a need to hire more people.

Cheryl Mayforth, Executive Director of The WorkPlace, says she is already looking to hire at least one person now to do the recertification.

“It could affect up to 950 families or households in Jefferson County alone, so it’s going to be a challenge,” said Mayforth.

For people who have to check in to keep their Medicaid, they’ll have to check a few boxes.

“They’re going to have to work at least 20 hours a week, 80 hours a month, and they’re going to have to report to us job searches, any volunteer work that they’re doing,” said Mayforth.

Mayforth says those on Medicaid will be exempt from re-certifying if they are 65 or older, disabled, or have a child under 14.

The Big Beautiful Bill also makes changes to who qualifies for SNAP, or the Supplemental Nutrition Assistance Program. It’ll use some of the same recertification as Medicaid.

Piche says in New York State, counties are responsible for administering SNAP, and currently, the state does not meet the new standards the federal government is trying to implement.

What does that mean? Piche says, hypothetically speaking, $5 million in penalties on Jefferson County taxpayers.

“The question is, are those penalties going to be paid by the state or are they going to be paid at the local level? If they’re paid at the local level, that means local taxpayers, on your property tax bills, are going to have to cover those penalties,” said Piche.

It’s important to note that there are still a lot of unknowns.

The changes go into effect in 2027, and Piche says the county will be working with other county governments and the state over the next year to learn more about how to best implement the changes.

Copyright 2025 WWNY. All rights reserved.


https://www.wwnytv.com/2025/07/22/could-big-beautiful-bills-medicaid-cuts-shift-work-expenses-county-level/


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STATE NEWS – Losing bidders accuse state officials of mishandling Medicaid contracts

STATE NEWS – Losing bidders accuse state officials of mishandling Medicaid contracts


Alternative Headline: Georgia Medicaid Contract Controversy


[MM Curator Summary]: Georgia’s Medicaid contract awards face legal protests amid claims of misconduct, favoritism, and transparency violations.

==============================


A bidding war for a massive contract to manage the state’s multibillion-dollar Medicaid health insurance program has devolved into allegations of misconduct against state officials.

The losing companies, Amerigroup and Peach State Health Plan, filed complaints with the state’s contracting office and with the Fulton County Superior Court.

Peach State Health Plan accuses the former commissioner of the Department of Community Health, Russel Carlson, of violating a strict period of silence meant to keep all bidders on an even footing.

The companies also accuse the department of withholding documents that it should have produced under the state’s transparency laws.

At stake, they say, is the fairness and legality of doling out a major state contract.

“The State’s procurement was mismanaged, rife with errors and reckless practices,” Peach State said in a December letter protesting the decision.

State officials contacted by The Atlanta Journal-Constitution did not address the allegations or say whether the contract would be rebid, citing the pending procurement process.

Carlson, who recently left his job with the state for an outside position, did not answer AJC reporters’ questions about the contract. In a joint statement, he and DCH said his departure was unrelated to the contract.

Georgia insures about 2.3 million people under Medicaid, a state-federal health insurance program for poor children and some poor, elderly and disabled adults. Since 2006 Georgia has outsourced the operation of the critical program to private health insurance companies under a handful of contracts.

In December, DCH awarded the contracts to four companies: CareSource, Humana Employers Health Plan of Georgia, Molina Health Care and United Health Care of Georgia. But those companies have not taken over the work while the protest plays out.

Whichever companies ultimately end up with the contract will be responsible for signing up doctors and hospitals to the company’s Medicaid plan, writing the checks for patient care and coordinating care for patients.

Amerigroup and Peach State Health Plan have held those contracts since the outsourcing began in 2006. Amerigroup manages the Medicaid insurance for about 460,000 Georgians, and Peach State Health Plan does it for about 700,000. The contract includes children in foster care as well as adult Medicaid recipients.

A third company, CareSource, covers 380,000 Georgians under the current contract. That company was selected to continue with the state and is not part of the protest.

Peach State alleges Carlson texted with a lobbyist for one of the competing bidders and offered to call him about the timing of the award. The contracting process was at that moment still in a “blackout period,” the complaint claims, meaning state officials were forbidden from discussing the contract with any of the bidders except through designated intermediaries.

In addition, the insurance companies allege the DCH violated the Georgia Open Records Act by failing to produce any text messages until prodded by a court filing, and then producing so few that the company says it was not a good faith effort.

As part of its protest, Amerigroup has accused Candice Broce, the commissioner of the Department of Human Services, of smearing its reputation and scapegoating the company. DHS is separate from DCH and determines eligibility for Medicaid. Amerigroup had sought to win a separate Medicaid contract that would allow the company to manage health care for children in foster care or otherwise under state custody.

The company referenced a letter Broce wrote to then-DCH Commissioner Caylee Noggle saying, “Amerigroup is often difficult to reach, even during normal business hours” and providers complain they do not get paid in a timely manner, prompting many to leave the network.

The state has postponed the contract start date until to 2026 while the protest plays out.

https://www.ajc.com/politics/2025/07/losing-bidders-accuse-state-officials-of-mishandling-medicaid-contracts/


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STATE NEWS – Losing bidders accuse state officials of mishandling Medicaid contracts

STATE NEWS – Losing bidders accuse state officials of mishandling Medicaid contracts


Alternative Headline: Georgia Medicaid Contract Controversy


[MM Curator Summary]: Georgia’s Medicaid contract awards face legal protests amid claims of misconduct, favoritism, and transparency violations.

==============================


A bidding war for a massive contract to manage the state’s multibillion-dollar Medicaid health insurance program has devolved into allegations of misconduct against state officials.

The losing companies, Amerigroup and Peach State Health Plan, filed complaints with the state’s contracting office and with the Fulton County Superior Court.

Peach State Health Plan accuses the former commissioner of the Department of Community Health, Russel Carlson, of violating a strict period of silence meant to keep all bidders on an even footing.

The companies also accuse the department of withholding documents that it should have produced under the state’s transparency laws.

At stake, they say, is the fairness and legality of doling out a major state contract.

“The State’s procurement was mismanaged, rife with errors and reckless practices,” Peach State said in a December letter protesting the decision.

State officials contacted by The Atlanta Journal-Constitution did not address the allegations or say whether the contract would be rebid, citing the pending procurement process.

Carlson, who recently left his job with the state for an outside position, did not answer AJC reporters’ questions about the contract. In a joint statement, he and DCH said his departure was unrelated to the contract.

Georgia insures about 2.3 million people under Medicaid, a state-federal health insurance program for poor children and some poor, elderly and disabled adults. Since 2006 Georgia has outsourced the operation of the critical program to private health insurance companies under a handful of contracts.

In December, DCH awarded the contracts to four companies: CareSource, Humana Employers Health Plan of Georgia, Molina Health Care and United Health Care of Georgia. But those companies have not taken over the work while the protest plays out.

Whichever companies ultimately end up with the contract will be responsible for signing up doctors and hospitals to the company’s Medicaid plan, writing the checks for patient care and coordinating care for patients.

Amerigroup and Peach State Health Plan have held those contracts since the outsourcing began in 2006. Amerigroup manages the Medicaid insurance for about 460,000 Georgians, and Peach State Health Plan does it for about 700,000. The contract includes children in foster care as well as adult Medicaid recipients.

A third company, CareSource, covers 380,000 Georgians under the current contract. That company was selected to continue with the state and is not part of the protest.

Peach State alleges Carlson texted with a lobbyist for one of the competing bidders and offered to call him about the timing of the award. The contracting process was at that moment still in a “blackout period,” the complaint claims, meaning state officials were forbidden from discussing the contract with any of the bidders except through designated intermediaries.

In addition, the insurance companies allege the DCH violated the Georgia Open Records Act by failing to produce any text messages until prodded by a court filing, and then producing so few that the company says it was not a good faith effort.

As part of its protest, Amerigroup has accused Candice Broce, the commissioner of the Department of Human Services, of smearing its reputation and scapegoating the company. DHS is separate from DCH and determines eligibility for Medicaid. Amerigroup had sought to win a separate Medicaid contract that would allow the company to manage health care for children in foster care or otherwise under state custody.

The company referenced a letter Broce wrote to then-DCH Commissioner Caylee Noggle saying, “Amerigroup is often difficult to reach, even during normal business hours” and providers complain they do not get paid in a timely manner, prompting many to leave the network.

The state has postponed the contract start date until to 2026 while the protest plays out.

https://www.ajc.com/politics/2025/07/losing-bidders-accuse-state-officials-of-mishandling-medicaid-contracts/


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STATE NEWS – How federal policy changes will affect Access Health CT plans

STATE NEWS – How federal policy changes will affect Access Health CT plans


Alternative Headline: CT Faces ACA, Medicaid Cuts


[MM Curator Summary]: Connecticut residents face rising health costs and coverage losses under Trump’s health policy overhaul, affecting ACA plans, Medicaid, and immigrant access.

==============================

Connecticut’s Democratic elected officials have been crisscrossing the state to warn about the impacts of Medicaid cuts in President Donald J. Trump’s “One Big Beautiful Bill.” The measure, along with other federal policy changes, will also impact people who purchase plans through state-based exchanges established by the Affordable Care Act. These plans are often referred to as “qualified health plans,” “marketplace plans” or “ACA plans.”

Roughly 150,000 residents purchase health insurance through Access Health CT, the state’s health insurance exchange. Many of the cuts to the exchange plans will happen before the widely-discussed changes to Medicaid, with some changes to the ACA plans going into effect as soon as this year.

Here’s what you need to know about those upcoming changes.

Enhanced premium tax credits

Around 90% of Connecticut residents who purchase a plan on the exchange receive financial support to help cover the cost. At the end of 2025, one type of subsidy, known as “enhanced premium tax credits,” is set to expire. As a result, Connecticut residents with exchange plans could expect to pay $1,700 more on average every year for their health insurance, according to Access Health CT. Over 135,000 people will lose at least some financial support. A fifth of those people, or roughly 27,000, will no longer be eligible for any financial assistance.

The federal government originally passed the “enhanced” premium tax credits in 2021 as part of the American Rescue Plan Act and extended them through the end of 2025 as part of the Inflation Reduction Act. The Affordable Care Act already provided financial assistance to people with qualifying incomes who purchased exchange plans. The enhanced subsidies in ARPA and the IRA were meant to give more financial support during COVID-19 to people who already received it, as well as provide some to people who made a bit too much to qualify for subsidies under the ACA.

Unless Congress extends the enhanced subsidies before the end of the year, they will expire on Dec. 31. People who make over 400% of the federal poverty level annually and qualify for enhanced subsidies based on their income and household size will no longer receive financial support. People who make less than 400% of the federal poverty level will still receive financial support, but it will be reduced. In 2025, 400% of the federal poverty level for a family of four equates to an annual income of roughly $127,000.

The expiration of the enhanced subsidies will also deal a major blow to Covered Connecticut, a program that provides no-cost exchange plans to residents who make too much to qualify for Medicaid but still earn 175% or less than the federal poverty level. Covered Connecticut currently provides more than 40,000 residents with no-cost health and dental coverage. The Department of Social Services estimates it would cost the state $30 million annually to continue the program.

State budget officials recently projected last fiscal year’s spending plan closed out with an almost $2.2 billion surplus.

A spokesperson for DSS said the agency is awaiting more guidance from federal agencies before reviewing the information with Gov. Ned Lamont. Once “he has decided on a course of action, the administration will discuss next steps with legislators and other relevant stakeholders. Any changes to revenue or appropriations resulting from the Trump budget will require legislative approval.”

Coverage for immigrants

Federal policy changes will also impact access to exchange plans for people with certain immigration status, with some measures going into effect almost immediately.

Beginning in August 2025, recipients of the Deferred Action for Childhood Arrivals program, or DACA, will no longer be eligible to enroll in health coverage through the exchange. The federal policy allowing them to access ACA plans only went into effect in November 2024 and was overturned by a “final rule” issued by the Centers for Medicare and Medicaid Services, or CMS, in June. Less than 200 Connecticut residents will be impacted by this change, according to Access Health CT.

As a result of the “big beautiful bill,” green card holders who can’t qualify for Medicaid because they haven’t been residents for a minimum of five years will no longer receive tax credits that allow them to purchase discounted plans on the exchange. This change will go into effect in January 2026 and will impact roughly 4,855 enrollees in Connecticut, according to data provided by Access Health CT to the comptroller’s office.

Effective January 2027, financial assistance will only be available to certain types of immigrants, including legal permanent residents, as well as people who entered the U.S. through the Cuban-Haitian Entrant Program. Roughly 11,000 residents, including refugees, asylees, trafficking survivors and humanitarian parolees will no longer qualify for financial assistance.

Changes to enrollment and income verification timelines

There are also pending administrative changes.

Generally, people can only enroll in an exchange plan between Nov. 1 and mid-January, but a “special enrollment period” allows people with incomes at or below 150% of the federal poverty level to enroll in any month. The special enrollment period provision will be eliminated on Aug. 25 of this year.

Also beginning Aug. 25, CMS will be changing the ways in which people must verify their incomes for financial help, including shortening the time period to submit documents from 150 days to 90 days. 

Click here for a broader list of federal changes to Access Health CT plans. 

Correction: A previous version of this story incorrectly reported that the enrollment period for the exchange plan ended in mid-December. It ends in mid-January.

https://ctmirror.org/2025/07/23/access-health-ct-federal-policy-big-beautiful-bill/




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STATE NEWS – Medicaid advisory committee meets – Mississippi Today

STATE NEWS – Medicaid advisory committee meets – Mississippi Today


Alternative Headline: Mississippi Medicaid Panel Reconvenes


[MM Curator Summary]: Mississippi’s Medicaid Advisory Committee resumed meetings after 19 months, now including required input from Medicaid beneficiaries per new federal rules.

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Cindy Bradshaw, executive director of the Mississippi Division of Medicaid, listens during a meeting of the Medicaid Advisory Committee at the Sillers Building, Friday, July 25, 2025, in Jackson. Credit: Vickie D. King/Mississippi Today

The committee tasked with advising the Mississippi Division of Medicaid met Friday for the first time in a year and a half. 

The meeting in Jackson was a primer on Medicaid programs and provided a financial update for new members, most of whom were appointed in 2024 but have not yet participated in a meeting. 

The Medicaid Advisory Committee offers expertise and opinions to the state Medicaid program about health care services. It is made up of doctors, hospital executives, managed care organization representatives and other Medicaid stakeholders. 

Medicaid Advisory Committee members during a meeting at the Sillers Building, Friday, July 25, 2025, in Jackson. Credit: Vickie D. King/Mississippi Today

It includes two members of the recently formed Beneficiary Advisory Council, a group of Medicaid members and their families who advise Medicaid on their experience with the program. 

New federal policy seeks to heighten the role that beneficiaries play in shaping Medicaid programs and policy by mandating that members of the council serve on the Medicaid Advisory Committee. Ten percent of the group must be composed of beneficiaries or their families, a proportion that will rise in the coming years. 

Both committees are mandated by the federal government to meet quarterly. 

The last Medicaid Advisory Committee meeting, formerly known as the Medical Care Advisory Committee, was held on Dec. 8, 2023. 

Meetings were first set back in 2024 because state leaders, who were formerly charged with selecting members, were slow to make appointments. A meeting scheduled for October was postponed after former executive director Drew Snyder announced his resignation

Medicaid Advisory Committee members during a meeting at the Sillers Building, Friday, July 25, 2025, in Jackson. Credit: Vickie D. King/Mississippi Today

Meetings were then delayed further while the agency worked to sort out a discrepancy between state law and new federal guidelines, which mandated that committee appointments be made by the executive director of Medicaid and include members of the then-unformed Beneficiary Advisory Council. The new guidelines took effect this month. 

State lawmakers proposed language in several bills earlier this year during the legislative session that would have conformed state law to federal regulations. Two such bills were vetoed by the governor. 

Medicaid Executive Director Cindy Bradshaw said the agency decided to “honor the language” of the vetoed bills, conforming to federal guidelines without updating state law. 

Medicaid Advisory Committee members during a meeting at the Sillers Building, Friday, July 25, 2025, in Jackson. Credit: Vickie D. King/Mississippi Today

The committee’s recommendations have played a crucial role in crafting state Medicaid policy in the past. In 2023, the advisory group’s recommendation contributed to the Legislature’s passage of extended Medicaid coverage for new mothers

Republish our articles for free, online or in print, under a Creative Commons license.

https://mississippitoday.org/2025/07/25/medicaid-advisory-committee-meets-for-the-first-time-since-2023/



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